Ellen Walker, MD

VIRTUAL SERVICES FOR 2022

For your convenience and safety in the setting of COVID-19, the practice operates fully virtually at present. All scheduling and coordination is done efficiently by phone, email and text. All appointments are held using a telemedicine platform. This means you can connect with me from your home, workplace, or while traveling without having to worry about illness or commute times.

CONSULTATION

This is your initial psychiatric evaluation. We will spend 75 minutes together. In the first hour, we will discuss your reasons for seeking help, and in the last 15 minutes, we will make a reasonable plan of action.  

Common reasons for seeking out a psychiatric consultation include, but are not limited to, the following:

  • you notice a change in your mood, your nerves, your thinking, or your behavior, and you don’t know why
  • you have medically unexplained physical symptoms
  • you’ve received psychiatric medications from your primary care doctor but they don’t seem to be working or your symptoms are not fully resolved
  • you’ve been taking psychiatric medications but are unsure if they are necessary, if they are working for you, or are concerned about side effects
  • you’ve been seeing a counselor or therapist and they recommend you see a psychiatrist
  • you are concerned that your ways of coping with stress are harmful such as overeating, restricting food, binge shopping, using alcohol, or using pain pills or other drugs

While a specific problem may bring you in, I believe that my clients are often most helped by gaining insight into and mastery over long-standing patterns in relationships, feelings, or behaviors.  These patterns have likely been helpful earlier in your life but seem to get in the way of your personal growth and meeting your goals. This approach (called psychodynamic or psychoanalytic treatment) tries to effect lasting change and build increased capacities to use over the course of your life, in addition to temporary symptom management.

Yes. Momentum and continuity are both key to helping you meet your goals. I understand that people are mobile and cannot always take the time to leave school, the office, or childcare commitments to come in for a session. I am happy to help you to work around all of that. Standard of care is that I must meet you in person once for your evaluation, however after that, as long as it is safe and will be therapeutic for you, I am happy to continue to treat you over a HIPAA approved teleconference service.

Yes, I use email for scheduling, medication refills, and for notifying me of any side effects you’re having with medications. I do not do psychotherapy nor can I effectively handle emergencies over email.

While insurance plans make therapy accessible to many, there are risks and considerations that should be thoughtfully considered. Like any other medical procedure, insurance companies will cover a portion of the costs of therapy. It is my ethical responsibility to recommend a plan or course of treatment that I believe will best help you, regardless of your insurance coverage/limits.  Additionally, many insurance companies require diagnostic information and regular “clinical reviews”. To some patients, such reviews can feel intrusive or concerning. Should your insurance company request such information, I will speak with you first. Some clients, for the above confidentiality reasons, choose not to use insurance for therapy.

Depending on your goals, therapy can take months to years. Keep in mind that all patterns take years to develop. Time is often required to recognize problematic patterns, un-learn them, and then to build new, more effective ways of coping with your life.

Like learning a language, becoming skilled at a sport, or practicing an instrument, understanding yourself and truly changing lifelong habits takes time, commitment, and practice. More frequency often helps therapy gain momentum and can be exponentially more effective. I see most patients 1-4 times weekly and will make a recommendation to you about frequency within the first several sessions.

We will meet for an initial period during which I will get to know you, you can get a sense of my style, discuss your history, and talk about what brings you into therapy. When I have gathered enough information to make a recommendation for you, we will discuss my impressions and how we might work together.

PSYCHOTHERAPY

Therapy is known as the “talking” treatment for changes in mood, anxiety, thinking, behavior, and issues related to relationships. There are many different types of therapy, but the core feature in all types of therapy is the relationship between the therapist and the patient. We will take the time during 50 minute therapy sessions to delve deeper into the reasons that you are seeking help. This will then give you the opportunity to make the necessary changes to feel better.

MEDICATION MANAGEMENT

In some situations, medication is helpful to decrease the intensity of overwhelming emotions or to help you to think more clearly. This will allow you to feel more in control and more motivated to handle any problems you may be having. Medication use can often help you so that you feel less overwhelmed and more able to engage in a meaningful way in therapy. Medication management appointments without psychotherapy last 30 minutes, and we will typically discuss if you are noticing a positive therapeutic effect as well as if you are experiencing any side effects. Then, we can decide whether to continue the medication at the same dose, increase the dose of medication, or switch to a different medication. It is often the case that medication management occurs in conjunction with psychotherapy. If that is the case for you, we will talk about how the medication is affecting you as is necessary during your 50 minute psychotherapy session.

COORDINATION OF CARE

Though our work together is confidential, I believe, where appropriate, in collaborating with your family and other professionals. This typically leads to more efficient and accurate sharing of information and produces quicker change. As part of your treatment, we will discuss when and if this is appropriate. Your written permission is required before I may talk with anyone.

Some examples when coordination of care is necessary or might be helpful to you are:

  • when I am helping you with medication management and you are working with another therapist
  • to notify your primary care doctor and other specialists treating you regarding any medication concerns
  • if you are having educational difficulties caused by psychiatric symptoms and might benefit from learning accomodations
  • if you have a caretaker who would benefit from understanding how to help you
SUPERVISION

Clinical teaching is one of my passions.  As such, I provide clinical supervision for fellow psychiatrists, psychotherapists, social workers, and nurse practitioners. I am licensed in the following states:  CA, UT, CO, NV, AZ, TX, VA, NC, and NY.